[Two cases of thalamic infarction presenting with "thalamic astasia"].

We report two cases of so-called 'thalamic astasia', associated with thalamic infarction. A 76-year-old-man suddenly noted to fall down to the left side without severe hemiparesis. An MRI showed an infarction in the superolateral portion of the right thalamus. Over eight weeks, his astasia gradually disappeared. A 69-year-old-man suddenly noted inability to stand with loss of balance. He showed mild hemiparesis, hypesthesia and cerebellar signs on the right side. Although right hemiparesis was slight, he was unable to stand by himself. An MRI demonstrated an infarction in the ventrolateral to ventroposterior portion of the left thalamus. Three weeks later, his symptoms except for cerebellar ataxia remarkably disappeared. The overlapped MRI lesions of these two cases were localized in the ventrolateral thalamus, such as Vimi (nucleus ventrointermedii internus), Vci (nucleus ventrocaudalis internus), Cemc (nucleus centralis thalami magnocellularis). These lesions are so-called 'vestibular thalamic nuclei', in which fibers from vestibulocerebellum are terminated. Involvement of the thalamic connectivity explains that two patients noted inability to stand. Thus we concluded that these two patients had thalamic astasia, described by Masdeu and Gorelick.

Japanese families who have lost children to cancer: a primary study.

By interviewing 13 Japanese families who have lost children to cancer within the past 3 years, the main caregiver for the sick child was found to always be the mother, and the mother was the leader whereas the father was a cooperator. These mothers tried to resolve their problems within the context of the relationship between the parents. This tendency relates to the structure of Japanese human relationships. The relationships between the mothers and fathers changed and became stronger or weaker. How fathers shared the mothers' burdens strongly influenced their relationships. To provide comprehensive care, health professionals must recognize the cultural influence on the family dynamics and the family's perceptions toward the illness.

[A case of signet ring cell carcinoma of the urinary bladder].

A 51-year-old man was hospitalized with complaints of gross hematuria and terminal micturition pain. Cystoscopy revealed a low columnar tumor at the dome of the bladder. Ultrasonography and X-ray CT also demonstrated the same shape of tumor and no evidence of invasion to adjacent organs. Gastrointestinal examination, including upper gastrointestinal series and barium enema failed to reveal any primary tumor. The serum CEA level was 2.3 ng/ml, which was not elevated. Total cystectomy with ileal conduit and adjuvant chemotherapy consisting of cyclophosphamide, adriamycin and cisplatinum was performed. He died of a recurrent tumor 2 years and 2 months after the operation. Besides our experience of primary signet ring cell carcinoma of the urinary bladder, a review of the literature is reported.